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Telemedicine in the Time of COVID-19 – Part 1 of 3

Published: Sep 14, 2020 by Brandon Smith

By: Todd Lacksonen & Brandon Smith

The COVID-19 pandemic has brought change and uncertainty to all sectors of society–the practice of medicine is no exception. Patients are afraid to see their physician for fear of contracting the virus; physicians and their staff are likewise concerned about contracting the virus from their patients.

As a result, telemedicine visits have become the new normal. Telemedicine visits cannot replace procedures or surgery requiring hands-on care, but can replace routine follow-ups and other patient encounters that have traditionally occurred in-person. Generally, telemedicine is defined as the delivery of care by a clinician in one location to a patient who is in another location. One of the side effects of increased utilization of telemedicine physicians have noticed is that “no show” rates have improved dramatically following the wide acceptance and adoption of telemedicine. The reason for this may be quite simple–it is often easier to connect to an electronic device in the comfort of one’s own home compared to having to break out of a meeting or travel some distance in bad weather for non-emergent and non-urgent care.

As a result of the pandemic, states have been revisiting their laws and regulations around telemedicine, including making reimbursement more attractive and comparable to in-office visits. State legislation and regulation regarding telemedicine most directly impacts public payors. Public payors such as Medicaid cover more than 1-in-4 Ohioans. Any increase in reimbursement rates makes telemedicine more attractive to providers. Commercial managed care plans have also, generally, raised their reimbursement rates for telemedicine visits due to the pandemic, but uncertainty remains about how long the changes will last.

Although legislative and regulatory changes have made it easier for providers to practice telemedicine, providers have also faced implementation challenges. For example, providers have had to absorb the costs of new technology and the IT requirements that come with it as well as training their staff on how best to use the equipment. Furthermore, there are related challenges following the telemedicine office visit such as being able to send the patient for clinical laboratory work.

While the COVID-19 pandemic has brought uncertainty, it has also presented opportunities to make changes to the practice of medicine that were, perhaps, long overdue. In Part 2, we will discuss the changes already implemented by the Ohio Department of Medicaid and the State Medical Board of Ohio as well as the changes proposed by House Bill 679.